ASA Meets with HHS Secretary Price and CMS Administrator Verma, Offers Input on Regulatory Relief

On June 20, 2017, Dr. Don Arnold, Chair of the ASA Committee on Quality Management & Departmental Administration, and ASA Director of Quality and Regulatory Affairs Matt Popovich met with Health and Human Services (HHS) Secretary Dr. Tom Price and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma to discuss regulatory burdens the medical community faces and solutions for assuaging such burdens. ASA was one of nine medical specialty organizations at the roundtable discussion.

ASA focused on three specific topics – burdens based upon regulation or accreditation standards that lack scientific rigor, burdens placed on quality program penalties and rural pass-through regulation. During the discussion, Dr. Arnold also brought to the attention of Secretary Price the 33 percent problem that anesthesiology continues to face. In that discussion, ASA offered that improving the conversion factor through HHS actions would allow for physician anesthesiologists to achieve better parity between Medicare payments and commercial payers as experienced by the rest of medicine.

In addition to written comments describing the burden, regulation and solution, Dr. Arnold requested CMS focus on the following solutions:

• HHS should work with accreditation organizations to identify and use national guidelines, such as those used for surgical attire, medication labeling, use of oxytocin and others which are based upon scientifically sound and defensible evidence. ASA offered to provide additional examples to HHS at a later date. When making local assessments, accreditation organizations should use guidelines that are outcomes-based and have undergone rigorous scientific review prior to enforcing strict adherence by local practice and facilities.
• CMS should lower the reporting threshold for Physician Quality Reporting System (PQRS) in the 2016 performance year to accommodate that those physicians and their practices who could not meet the high thresholds of reporting nine measures across three National Quality Strategy domains. Such eligible professionals who attempted to participate in PQRS should have an opportunity to avoid unfair penalties in 2018.
• CMS should remove the negative value-based payment modifier (VM) for practices that attempted to report a minimum of PQRS measures or, because of continuing problems with patient attribution, had patients inaccurately attributed to their practices. Facing a 4 percent cut to their Medicare payments in 2018, ASA advocated for CMS to do away with negative adjustments under the VM.
• HHS should ensure that the rural pass-through program include physician anesthesiologists. Such a program should be amended to permit physician anesthesiologists to be paid on the reasonable cost basis under Part A. ASA supports H.R. 2881 in this effort as well.

In the weeks ahead, ASA expects to work with the Secretary and other Administration leaders to address these and other regulatory burdens in a constructive way that protects patient safety and allows for greater physician control of their practice.

For more information, please contact ASA Advocacy at [email protected]